Well Spouse Association

In this survey, a "well spouse" is the spouse / partner of a person with a disability or illness. 

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* 1. I am (check all that apply):

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* 2. My spouse / partner (check all that apply):

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* 3. I learned about the Well Spouse Association from (web search, friend, Facebook, etc.):

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* 4. My primary challenges as a Well Spouse relate to (check all that apply):

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* 5. These are the Well Spouse Association benefits that I find MOST valuable (pick all that apply):

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* 6. These are the membership benefits that I find LEAST valuable:

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* 7. When it comes to using these membership benefits:

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* 8. I'd like to volunteer with the Well Spouse Association by: 

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* 9. The best way for the Well Spouse Association to reach me is by:

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* 10. Here's how likely I am to recommend the Well Spouse Association to a friend with an ill or disabled partner:

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